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Wondering if this is normal?



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Hi all

I am due to have my bypass surgery on 4th January and am ready to start my liver reducing diet. I was due to see the dietician tomorrow but she cancelled due to illness. So far all I have had is one zoom call with the surgeon and two letters, one confirming op date and one for the now cancelled dietician appointment with some info on the pre op diet.
I have read through this forum and notice that people have had pre op bloods, had to lose weight to have the surgery, had to see the psychiatrist, anaesthetist etc. but I have literally seen nobody and my op is in 3 weeks!

I am paying privately for the op, so not on the nhs, and it with a reputable company but I’m just finding it odd. Is this normal for such a huge operation when you pay privately? Feels strange to me

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I went through insurance but I know someone who paid privately and she didn’t have to go through all the hurdles either. I am not sure if she had to do labs or not but she didn’t have to see the nutritionist or the psychiatrist. Which was all I had to do with insurance. The other medical stuff is as needed to determine you are fit for surgery or to prove comirbidites to insurance companies so it varies person to person. If you think you may have disordered eating (like boredom or emotional eating or binge eating) I would definitely see a bariatric therapist whether they require it or not. I learned after surgery about boredom and emotional eating and I struggle with both. I wish the psychiatrist I had to see had picked up on this so I could have dealt with it before surgery. I wanted the surgery asap but I feel the process has been harder for me dealing with my disordered eating while also doing weight loss phase.

Edited by ShoppGirl

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Guest

2 hours ago, Doodle41 said:

Hi all

I am due to have my bypass surgery on 4th January and am ready to start my liver reducing diet. I was due to see the dietician tomorrow but she cancelled due to illness. So far all I have had is one zoom call with the surgeon and two letters, one confirming op date and one for the now cancelled dietician appointment with some info on the pre op diet.
I have read through this forum and notice that people have had pre op bloods, had to lose weight to have the surgery, had to see the psychiatrist, anaesthetist etc. but I have literally seen nobody and my op is in 3 weeks!

I am paying privately for the op, so not on the nhs, and it with a reputable company but I’m just finding it odd. Is this normal for such a huge operation when you pay privately? Feels strange to me

I was in the private system, too. I had four meetings - one with a medical doctor (including going over blood work), one with the surgeon, one with a dietician and a group follow-up with the dietician. That was it. I had to lose 5% of my bodyweight prior to surgery, and only for the liver, not the weird moral/punishment stuff American programs seem to do.

I had some heart stuff they needed to figure out, but that was in the public system (and turned out to be nothing).

Edited by Guest

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The pre surgical requirements seem to be different in the UK than the US. They’re certainly different in Australia. Here your surgical approval is not given by your health fund & is not dependent upon having a therapy assessment, going to a series of dietician appointments & not does it take a prolonged length of time.

Check with your surgeon’s office as to what you will need to do. Good luck with your surgery.

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5 hours ago, Doodle41 said:

Hi all

I am due to have my bypass surgery on 4th January and am ready to start my liver reducing diet. I was due to see the dietician tomorrow but she cancelled due to illness. So far all I have had is one zoom call with the surgeon and two letters, one confirming op date and one for the now cancelled dietician appointment with some info on the pre op diet.
I have read through this forum and notice that people have had pre op bloods, had to lose weight to have the surgery, had to see the psychiatrist, anaesthetist etc. but I have literally seen nobody and my op is in 3 weeks!

I am paying privately for the op, so not on the nhs, and it with a reputable company but I’m just finding it odd. Is this normal for such a huge operation when you pay privately? Feels strange to me

Hi Doodle, Welcome in the forum.

I had my surgery 3 weeks ago in a Northern Spire Hospital and I paid it myself. I started the process back in April this year and at the time seemed to dawdle along. I first saw the surgeon, he explained his bit. Then I saw the dietician, She told me what to prepare for and gave me great information, eg using this site. Then I had a half an hour zoom call with a psychiatrist, To check if I actually knew what the process entailed and if I was mentally fit to decide. Then I saw the surgeon to sign for the surgery, a great waste of time as they could have posted it to me. Then I began 3 weeks of the liver shrink diet. Two days before surgery I had bloodwork done and a ECG. I had to do Lateral flow tests every visit to the hospital. .

If you are unsure about any part of your journey, ring your hospital and ask to speak to someone. You are paying for it after all. You need as much info as you can get. One thing I have learned is no-one has the same route to surgery. Where these surgeons get their liver diets and post surgery rules from is any ones guess, hardly any one person has the same journey as another. My hospital care was outstanding btw. I wouldnt change a thing

Good luck with your journey

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some of those things are requirements of the insurance companies, not the surgeons. Since you're self-pay, it makes sense you may not have to deal with as many requirements as other people.

also, I've had several surgeries - the only time I've ever met with the anesthesiologists is about an hour before they roll me into the operating room.

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15 hours ago, Doodle41 said:

Is this normal for such a huge operation when you pay privately? Feels strange to me

Hi @Doodle41, welcome to the forum!

I paid privately but in the US. This is what I had:

  • Initial appointment with Surgeon. Requested medical clearance from the primary physician (PCP). Gave me a schedule of what would happen for the next month until surgery, what tests, clearances, etc, I needed to get.
  • Appointment with PCP. Blood work, chest x-ray. Referred me to a cardiologist, for cardiac release.
  • Appointment with Cardiologist. EKG, Echocardiogram. Skipped the stress test, since I had one less than a year prior.
  • Endoscopy (performed by VSG surgeon)
  • Appointment with surgeon 1-week pre-op.
  • Zoom call with the psychologist.
  • Surgery.
  • Appointment with surgeon 1-week post-op

You still have almost 2.5-3 weeks until surgery. Whatever is missing can still be accomplished, but require transparency from your team.. IMO.

If you are not comfortable with the process so far, call your surgical team, and ask them for details as to what's next, and don't be shy to postpone the surgery until you get the answers.

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I paid privately (in Belgium) and literally had one visit with the surgeon (lasted about 10 minutes) and one meeting with a dietician (lasted about 5 minutes). And that’s it. Choose which surgery I would want and picked a surgery date.
Since I had quite a low starting BMI (35.5), I didn’t have to do another appointment with the dietician. Other people had to record their eating for a week and discuss that with the dietician. 🤷🏻‍♀️
Leading up to the surgery I also had to do some bloodwork through my GP. But that’s it. Got a leaflet explaining the pre-op diet and that’s it. 😅
I already knew everything I needed to know since I did lots of research myself, so I didn’t really mind all of this, but it did seem quite weird to me, compared to the hoops people have to jump through for insurance.
One advantage of being self payed was that at my hospital they always do the self-pay patients first, so I was actually first of the day and done by 9 in the morning. 👍🏻

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Nearly all of my stuff was in the two weeks prior to surgery, so don't fret. I had:

- clearance from a psychologue

- EKG

- one meeting with a dietitian

- one support group meeting

- blood tests

- final clearance from my normal family doctor

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